Mental health care (outpatient)

How often is it covered?

Medicare Part B (Medical Insurance) covers mental health services and visits with these types of health professionals:

  • Psychiatrist or other doctor
  • Clinical psychologist
  • Clinical social worker
  • Clinical nurse specialist
  • Nurse practitioner
  • Physician assistant

Medicare only covers these visits, often called counseling or therapy, when they’re provided by a health care provider who accepts assignment.  Search provider list.

Part B covers outpatient mental health services, including services that are usually provided outside a hospital, like in these settings:

  • A doctor’s or other health care provider’s office
  • A hospital outpatient department
  • A community mental health center

Part B also covers outpatient mental health services for treatment of inappropriate alcohol and drug use.

Part B helps pay for these covered outpatient services:

  • One depression screening per year. The screening must be done in a primary care doctor’s office or primary care clinic that can provide follow-up treatment and referrals.
  • Individual and group psychotherapy with doctors or certain other licensed professionals allowed by the state where you get the services.
  • Family counseling, if the main purpose is to help with your treatment.
  • Testing to find out if you’re getting the services you need and if your current treatment is helping you.
  • Psychiatric evaluation.
  • Medication management.
  • Certain prescription drugs that aren’t usually “self administered”(drugs you would normally take on your own), like some injections.
  • Diagnostic tests.
  • Partial hospitalization.
  • A one-time “Welcome to Medicare” preventive visit. This visit includes a review of your potential risk factors for depression.
  • yearly “Wellness” visit. This is a good time to talk to your doctor or other health care provider about changes in your mental health so they can evaluate your changes year to year.

Medicare & Mental Illness # 10184
Medicare & Mental Illness # 10184

 

  Medicare & You – Mental Health
Find Medicare MD
Find Medicare MD

Who’s eligible?

All people with Part B are covered.

Your costs in Original Medicare

  • You pay nothing for your yearly depression screening if your doctor or health care provider accepts assignment.
  • 20% of the Medicare-approved amount for visits to a doctor or other health care provider to diagnose or treat your condition. The Part B deductible applies.
  • If you get your services in a hospital outpatient clinic or hospital outpatient department, you may have to pay an additional copayment or coinsurance amount to the hospital.  Copied from Medicare.Gov

See our page on

Mental Health – ACA Obamacare

Special Needs Plans – Mental Health

To get immediate quotes, information and enroll ONLINE,
click here for Blue Cross and here for Blue Shield

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